Managed Care

RECIPIENTS ELIGIBLE FOR ENROLLMENT IN MANAGED CARE:ENROLLMENT STATUS BY AID CATEGORY AND COUNTY,AND TOTAL PERCENT ENROLLED BY PROVIDER PLAN

NYS November, 2002

TANF ADC & MA-ADC

SNA HR & MA-HR

TANF & MA-ADC, SNA & MA-HR

EXPECTED PENETRATION RATE

SSI & MA-SSI

County

Provider

Eligibles

Enrolled

Eligibles

Enrolled

Total Eligibles

Total Enrolled

Percent Enrolled

Expected Target*

% of Target*

Eligibles

Enrolled

Total Eligibles

Total Enrolled

Percent Enrolled

Albany

TOTALS:

15,427

12,512

1,856

1,023

17,283

13,535

78%

92%

85%

4,299

831

21,582

14,366

67%

CDPHP

10,425

866

11,291

65%

719

12,010

56%

Fidelis/NYS Catholic Hlth

1,101

98

1,199

7%

73

1,272

6%

Wellcare

986

59

1,045

6%

39

1,084

5%

Allegany

TOTALS:

3,523

846

331

54

3,854

422

11%

90%

12%

1,005

200

4,859

1,100

23%

Health Choice (Partial)

399

23

422

11%

174

596

12%

HealthNow/BCBS-WNY/Community Blue

447

31

478

12%

26

504

10%

Broome

TOTALS:

11,751

10,267

1,234

831

12,985

11,098

85%

90%

95%

3,461

915

16,446

12,013

73%

Broome MC

5,052

319

5,371

41%

690

6,061

37%

Fidelis/NYS Catholic Hlth

418

39

457

4%

21

478

3%

CDPHP

4,797

473

5,270

41%

204

5,474

33%

Cattauragus

TOTALS:

5,652

4,307

352

263

6,004

4,570

76%

91%

83%

1,568

581

7,572

5,151

68%

HealthNow/BCBS-WNY/Community Blue

3,292

210

3,502

58%

522

4,024

53%

Fidelis/NYS Catholic Hlth

1,015

53

1,068

18%

59

1,127

15%

Cayuga

TOTALS:

4,776

0

275

0

5,051

0

0%

89%

0%

1,164

0

6,215

0

0%

Chautauqua

TOTALS:

11,149

8,422

1,446

913

12,595

9,335

74%

85%

87%

2,619

1,028

15,214

10,363

68%

HealthNow/BCBS-WNY/Community Blue

2,749

236

2,985

24%

312

3,297

22%

Primary Health

594

90

684

5%

233

917

6%

Fidelis/NYS Catholic Hlth

5,079

587

5,666

45%

483

6,149

40%

Chemung

TOTALS:

7,521

3,724

593

214

8,114

3,938

49%

89%

55%

1,918

977

10,032

4,915

49%

Southern Tier Pediatrics (Partial)

2,654

0

2,654

33%

262

2,916

29%

Southern Tier Priority (Partial)

1,070

214

1,284

16%

715

1,999

20%

Chenango

TOTALS:

4,074

0

203

0

4,277

0

0%

92%

0%

968

0

5,245

0

0%

Clinton

TOTALS:

5,205

0

414

0

5,619

0

0%

86%

0%

1,547

0

7,166

0

0%

Columbia

TOTALS:

2,883

2,234

239

145

3,122

2,379

76%

93%

82%

856

176

3,978

2,555

64%

CDPHP

1,746

114

1,860

60%

146

2,006

50%

Wellcare

347

20

367

12%

26

393

10%

Fidelis/NYS Catholic Hlth

141

11

152

5%

4

156

4%

Cortland

TOTALS:

3,729

340

259

14

3,988

354

9%

91%

10%

779

88

4,767

442

9%

Fidelis/NYS Catholic Hlth

340

14

354

9%

88

442

9%

Delaware

TOTALS:

2,468

120

217

7

2,685

127

5%

92%

5%

755

4

3,440

131

4%

Wellcare

120

7

127

5%

4

131

4%

Dutchess

TOTALS:

8,117

1,381

700

33

8,817

1,414

16%

90%

18%

2,593

109

11,410

1,523

13%

Wellcare

1,381

33

1,414

16%

109

1,523

13%

Erie

TOTALS:

61,532

49,164

8,341

4,500

69,873

53,664

77%

93%

83%

17,191

7,229

87,064

60,893

70%

Buffalo Community Health

6,785

474

7,259

10%

265

7,524

9%

HealthNow/BCBS-WNY/Community Blue

9,472

815

10,287

15%

875

11,162

13%

Independent Health Assoc/IHA

18,341

1,404

19,745

28%

1388

21,133

24%

Fidelis/NYS Catholic Hlth

13,909

771

14,680

21%

1276

15,956

18%

Total Full Risk

48,507

3,464

51,971

74%

3,804

55,775

64%

PCMP II (Partial)

114

39

153

0%

297

450

1%

PCMP III (Partial)

27

37

64

0%

375

439

1%

PCMP II-A Special Care (Partial)

516

960

1,476

2%

2753

4,229

5%

Total Partial Risk

657

1,036

1,693

2%

3,425

5,118

6%

Essex

TOTALS:

1,793

0

143

0

1,936

0

0%

92%

0%

585

0

2,521

0

0%

Franklin

TOTALS:

3,092

0

245

0

3,337

0

0%

91%

0%

993

0

4,330

0

0%

Fulton

TOTALS:

4,617

836

390

40

5,007

876

17%

92%

19%

1,080

34

6,087

910

15%

CDPHP

836

40

876

17%

34

910

15%

Genesee

TOTALS:

2,791

1,334

134

74

2,925

1,408

48%

89%

54%

615

99

3,540

1,507

43%

HealthNow/BCBS-WNY/Community Blue

105

4

109

4%

2

111

3%

Preferred Care

1,229

70

1,299

44%

97

1,396

39%

Greene

TOTALS:

2,834

2,339

274

143

3,108

2,482

80%

93%

86%

683

200

3,791

2,682

71%

CDPHP

1,522

97

1,619

52%

143

1,762

46%

Wellcare

600

30

630

20%

45

675

18%

Fidelis/NYS Catholic Hlth

217

16

233

7%

12

245

6%

Hamilton

TOTALS:

131

0

13

0

144

0

0%

91%

0%

47

0

191

0

0%

Herkimer

TOTALS:

4,188

1,188

269

81

4,457

1,269

28%

92%

31%

882

54

5,339

1,323

25%

Fidelis/NYS Catholic Hlth

535

43

578

13%

32

610

11%

United Healthcare of Upstate

653

38

691

16%

22

713

13%

Jefferson

TOTALS:

7,641

0

667

0

8,308

0

0%

87%

0%

1,878

0

10,186

0

0%

Lewis

TOTALS:

2,033

0

137

0

2,170

0

0%

93%

0%

401

0

2,571

0

0%

Livingston

TOTALS:

3,054

2,064

274

150

3,328

2,214

67%

92%

73%

676

165

4,004

2,379

59%

Excellus

1,307

103

1,410

42%

71

1,481

37%

Preferred Care

757

47

804

24%

94

898

22%

Madison

TOTALS:

3,208

0

168

0

3,376

0

0%

91%

0%

754

0

4,130

0

0%

Monroe

TOTALS:

49,621

41,592

7,667

4,136

57,288

45,728

80%

91%

87%

12,204

2,990

69,492

48,718

70%

Excellus

30,528

3,166

33,694

59%

2377

36,071

52%

Preferred Care

11,064

970

12,034

21%

613

12,647

18%

Montgomery

TOTALS:

3,957

872

400

29

4,357

901

21%

92%

23%

793

60

5,150

961

19%

CDPHP

872

29

901

21%

60

961

19%

Nassau

TOTALS:

31,402

22,979

3,147

1,590

34,549

24,569

71%

92%

77%

10,096

1,373

44,645

25,942

58%

Vytra

2,653

128

2,781

8%

145

2,926

7%

HIP

4,539

501

5,040

15%

466

5,506

12%

HealthFirst PHSP

5,518

324

5,842

17%

263

6,105

14%

Affinity Health Plan

4,815

197

5,012

15%

234

5,246

12%

Fidelis/NYS Catholic Hlth

3,569

248

3,817

11%

153

3,970

9%

United Healthcare of NY

1,885

192

2,077

6%

112

2,189

5%

Niagara

TOTALS:

12,180

11,167

1,423

840

13,603

12,007

88%

93%

95%

3,363

1,503

16,966

13,510

80%

Independent Health Assoc/IHA

5,297

408

5,705

42%

808

6,513

38%

Fidelis/NYS Catholic Hlth

1,979

164

2,143

16%

290

2,433

14%

HealthNow/BCBS-WNY/Community Blue

3,891

268

4,159

31%

405

4,564

27%

Oneida

TOTALS:

16,722

14,020

1,678

1,090

18,400

15,110

82%

92%

89%

5,139

1,397

23,539

16,507

70%

Fidelis/NYS Catholic Hlth

7,755

623

8,378

46%

984

9,362

40%

United Healthcare of Upstate

4,901

320

5,221

28%

369

5,590

24%

Excellus

1,364

147

1,511

8%

44

1,555

7%

Onondaga

TOTALS:

30,565

24,133

3,121

1,633

33,686

25,766

76%

89%

86%

7,805

2,257

41,491

28,023

68%

Fidelis/NYS Catholic Hlth

5,354

338

5,692

17%

554

6,246

15%

Total Care/Syracuse PHSP

9,665

657

10,322

31%

1029

11,351

27%

United Healthcare of Upstate

7,024

482

7,506

22%

601

8,107

20%

Excellus

2,090

156

2,246

7%

73

2,319

7%

Ontario

TOTALS:

4,100

3,470

347

147

4,447

3,617

81%

91%

89%

1,090

371

5,537

3,988

72%

Excellus

2,790

112

2,902

65%

307

3,209

58%

Preferred Care

680

35

715

16%

64

779

14%

Orange

TOTALS:

22,281

6,017

3,563

310

25,844

6,327

24%

91%

27%

4,116

688

29,960

7,015

23%

Affinity Health Plan

4,510

228

4,738

18%

591

5,329

18%

Wellcare

1,319

56

1,375

5%

87

1,462

5%

Westchester PHSP

188

26

214

1%

10

224

1%

Orleans

TOTALS:

3,101

1,143

300

72

3,401

1,215

36%

92%

39%

612

83

4,013

1,298

32%

Excellus

467

29

496

15%

46

542

14%

Fidelis/NYS Catholic Hlth

486

25

511

15%

26

537

13%

HealthNow/BCBS-WNY/Community Blue

190

18

208

6%

11

219

5%

Oswego

TOTALS:

9,386

7,957

706

459

10,092

8,416

83%

92%

90%

1,943

594

12,035

9,010

75%

Fidelis/NYS Catholic Hlth

1,553

108

1,661

16%

100

1,761

15%

Total Care/Syracuse PHSP

2,792

205

2,997

30%

244

3,241

27%

United Healthcare of Upstate

3,606

146

3,752

37%

250

4,002

33%

Excellus

6

0

6

0%

0

6

0%

Otsego

TOTALS:

2,857

27

154

0

3,011

27

1%

91%

1%

831

1

3,842

28

1%

Wellcare

27

0

27

1%

1

28

1%

Putnam

TOTALS:

938

139

157

13

1,095

152

14%

88%

16%

548

34

1,643

186

11%

Care Plus Health Plan

139

13

152

14%

34

186

11%

Rensselaer

TOTALS:

8,122

7,355

895

639

9,017

7,994

89%

92%

96%

2,160

433

11,177

8,427

75%

CDPHP

6,424

564

6,988

77%

369

7,357

66%

Fidelis/NYS Catholic Hlth

635

47

682

8%

44

726

6%

Wellcare

269

25

294

3%

18

312

3%

HealthNow/BlueShield of NENY

27

3

30

0%

2

32

0%

Rockland

TOTALS:

20,437

19,987

1,364

737

21,801

20,724

95%

92%

103%

2,644

527

24,445

21,251

87%

Affinity Health Plan

1,420

102

1,522

7%

120

1,642

7%

Fidelis/NYS Catholic Hlth

13,817

366

14,183

65%

236

14,419

59%

Wellcare

2,076

86

2,162

10%

51

2,213

9%

Westchester PHSP

2,549

161

2,710

12%

108

2,818

12%

Community Choice Hlth Plan

125

22

147

1%

12

159

1%

St. Lawrence

TOTALS:

7,889

0

742

0

8,631

0

0%

91%

0%

2,446

0

11,077

0

0%

Saratoga

TOTALS:

5,215

4,332

370

225

5,585

4,557

82%

92%

89%

1,897

217

7,482

4,774

64%

Wellcare

45

5

50

1%

0

50

1%

CDPHP

3,627

180

3,807

68%

195

4,002

53%

Fidelis/NYS Catholic Hlth

660

40

700

13%

22

722

10%

Schenectady

TOTALS:

8,665

6,111

773

362

9,438

6,473

69%

90%

76%

2,520

691

11,958

7,164

60%

CDPHP

5,528

313

5,841

62%

630

6,471

54%

Fidelis/NYS Catholic Hlth

583

49

632

7%

61

693

6%

Schoharie

TOTALS:

1,868

68

111

3

1,979

71

4%

92%

4%

384

5

2,363

76

3%

CDPHP

68

3

71

4%

5

76

3%

Schuyler

TOTALS:

1,199

0

118

0

1,317

0

0%

92%

0%

330

0

1,647

0

0%

Seneca

TOTALS:

1,720

1,160

131

32

1,851

1,192

64%

92%

70%

450

171

2,301

1,363

59%

Excellus

1,160

32

1,192

64%

171

1,363

59%

Steuben

TOTALS:

6,960

1,909

582

161

7,542

2,070

27%

91%

30%

2,080

616

9,622

2,686

28%

Southern Tier Pediatrics (Partial)

103

0

103

1%

12

115

1%

Southern Tier Priority (Partial)

1,806

161

1,967

26%

604

2,571

27%

Suffolk

TOTALS:

41,557

33,793

3,716

1,863

45,273

35,656

79%

91%

86%

13,281

2,714

58,554

38,370

66%

Vytra

3,236

117

3,353

7%

291

3,644

6%

HIP

4,294

471

4,765

11%

245

5,010

9%

HealthFirst PHSP

5,156

213

5,369

12%

527

5,896

10%

Suffolk Plan HMO

9,646

493

10,139

22%

1173

11,312

19%

Affinity Health Plan

3,547

155

3,702

8%

169

3,871

7%

United Healthcare of NY

5,248

244

5,492

12%

164

5,656

10%

Fidelis/NYS Catholic Hlth

2,666

170

2,836

6%

145

2,981

5%

Sullivan

TOTALS:

5,080

1,692

285

42

5,365

1,734

32%

91%

36%

1,442

118

6,807

1,852

27%

Wellcare

536

15

551

10%

54

605

9%

Westchester PHSP

1,156

27

1,183

22%

64

1,247

18%

Tioga

TOTALS:

2,631

65

175

2

2,806

67

2%

92%

3%

714

0

3,520

67

2%

CDPHP

65

2

67

2%

0

67

2%

Tompkins

TOTALS:

4,137

0

496

0

4,633

0

0%

90%

0%

982

0

5,615

0

0%

Ulster

TOTALS:

8,568

2,383

783

101

9,351

2,484

27%

91%

29%

2,566

176

11,917

2,660

22%

Wellcare

2,383

101

2,484

27%

176

2,660

22%

Warren

TOTALS:

2,723

1,736

173

9

2,896

1,745

60%

92%

66%

883

67

3,779

1,812

48%

HealthNow/BlueShield of NENY

1,736

9

1,745

60%

67

1,812

48%

Washington

TOTALS:

3,255

1,385

215

30

3,470

1,415

41%

91%

45%

933

134

4,403

1,549

35%

HealthNow/BlueShield of NENY

898

22

920

27%

111

1,031

23%

CDPHP

487

8

495

14%

23

518

12%

Wayne

TOTALS:

3,877

2,918

218

124

4,095

3,042

74%

92%

81%

1,205

274

5,300

3,316

63%

Excellus

861

37

898

22%

91

989

19%

Preferred Care

2,057

87

2,144

52%

183

2,327

44%

Westchester

TOTALS:

44,491

32,580

5,916

2,465

50,407

35,045

70%

89%

79%

9,969

2,496

60,376

37,541

62%

HIP

2,615

451

3,066

6%

321

3,387

6%

Westchester PHSP

16,320

892

17,212

34%

1066

18,278

30%

Affinity Health Plan

5,206

386

5,592

11%

457

6,049

10%

Community Choice Hlth Plan

5,655

473

6,128

12%

440

6,568

11%

Fidelis/NYS Catholic Hlth

2,784

263

3,047

6%

212

3,259

5%

Wyoming

TOTALS:

1,652

0

120

0

1,772

0

0%

91%

0%

416

0

2,188

0

0%

Yates

TOTALS:

1,314

1,022

72

43

1,386

1,065

77%

93%

83%

284

78

1,670

1,143

68%

Excellus

1,022

43

1,065

77%

78

1,143

68%

Upstate Total

551,659

353,090

59,092

25,642

610,751

378,254

62%

91%

68%

145,443

32,758

756,194

411,490

54%

NYC

Affinity Health Plan

58,640

7,043

65,683

5%

2,962

68,645

5%

Fidelis/NYS Catholic Hlth

49,264

7,233

56,497

4%

1,907

58,404

4%

HealthFirst PHSP

79,054

12,223

91,277

7%

5,141

96,418

6%

HIP

90,452

24,816

115,268

9%

7,802

123,070

8%

Health Plus PHSP

88,002

12,269

100,271

8%

2,338

102,609

7%

AmeriChoice of New York/MHS

56,028

14,196

70,224

6%

3,542

73,766

5%

Manhattan PHSP/Center Care

44,100

7,051

51,151

4%

1,787

52,938

4%

MetroPlus Health Plan

75,944

11,445

87,389

7%

4,275

91,664

6%

United Healthcare of NY

12,078

4,053

16,131

1%

539

16,670

1%

St Barnabas/Partners in Health

17,111

2,477

19,588

2%

1,134

20,722

1%

Neighborhood Health Providers

48,685

4,900

53,585

4%

1,756

55,341

4%

Wellcare

13,879

2,576

16,455

1%

426

16,881

1%

ABC Health Plan

6,271

1,042

7,313

1%

169

7,482

0%

Community Choice Hlth Plan

3,672

656

4,328

0%

76

4,404

0%

Community Premier Plus

15,933

1,987

17,920

1%

1,015

18,935

1%

NY Hospital Community PHSP

21,371

4,190

25,561

2%

874

26,435

2%

Care Plus Health Plan

36,129

4,611

40,740

3%

990

41,730

3%

NYC Total

1,017,540

716,613

238,069

122,768

1,255,609

839,381

67%

90%

74%

253,686

36,733

1,509,295

876,114

58%

UPSTATE TOTALS:

551,659

353,090

59,092

25,642

610,751

378,254

62%

91%

68%

145,443

32,758

756,194

411,490

54%

NEW YORK CITY TOTALS:

1,017,540

716,613

238,069

122,768

1,255,609

839,381

67%

90%

74%

253,686

36,733

1,509,295

876,114

58%

GRAND TOTALS

1,569,199

1,069,703

297,161

148,410

1,866,360

1,217,635

65%

91%

72%

399,129

69,491

2,265,489

1,287,604

57%

NYC Boroughs

Bronx

268,951

207,578

58,468

29,987

327,419

237,566

73%

64,258

9,472

391,677

247,037

63%

Brooklyn

374,235

274,483

91,460

54,875

465,695

329,357

71%

88,334

13,679

554,029

343,036

62%

Manhattan

150,392

64,483

46,471

12,084

196,863

76,567

39%

48,934

5,464

245,797

82,031

33%

Queens

197,848

146,573

36,673

22,278

234,521

168,851

72%

44,340

6,265

278,861

175,116

63%

Staten Island

26,114

23,495

4,997

3,545

31,111

27,040

87%

7,820

1,853

38,931

28,894

74%

Borough Total

1,017,540

716,613

238,069

122,768

1,255,609

839,381

67%

90%

74%

253,686

36,733

1,509,295

876,114

58%

NOTES:

The Managed Care eligible counts are based upon January, 2002 total eligibles adjusted for excluded populations. The counts include recipients who are exempt from mandatory enrollment. (See about statement for further details)

The source of plan enrollment counts was revised in March, 1999 to be based on the Medicaid Encounter Data System (MEDS). The MEDS data reflects enrollees as of the end of the enrollment month. (See about statement for further details)

All percents are rounded to the nearest whole number.

The expected penetration rate columns reflect an adjustment to total eligibles and the percent enrolled to account for the portion of the exempt population who are expected to choose not to enroll in managed care and for retroactive Medicaid eligibility determinations precluding enrollment for the month being measured. (An exempt recipient is one who will not be mandated to enroll in Medicaid managed care, but is eligible to enroll voluntarily. This would include Medicaid recipients with AIDS, HIV or a serious and persistent mental illness. See the about statement for further details of this adjustment).

New plans added this month: Oswego County - Excellus Rensselaer County - HealthNow/BlueShield of NENY